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Multimorbidity Management: Balancing Complex Health Needs

This educational material focuses on the impact of managing patients with multiple chronic conditions, emphasizing a 5-step approach that incorporates patient preferences, evidence-based treatments, prognosis estimation, clinical feasibility, and prioritization of care plans. Multimorbidity, the coexistence of multiple chronic diseases, affects a significant percentage of Medicare recipients and consumes a substantial portion of the healthcare budget. Learn how to navigate the complexities of multimorbid patients effectively and efficiently. Practice case scenarios in small groups to develop personalized plans that optimize patient outcomes.

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Multimorbidity Management: Balancing Complex Health Needs

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  1. MULTIMORBIDITY:THE MOST COMMON CHRONIC CONDITION Katherine Thompson, MD; Mariko Wong, MD; Megan Huisingh-Scheetz, MD, MPH University of Chicago, Pritzker School of Medicine Clinical Skills

  2. MULTIMORBIDITY • Goal: Learn to balance competing recommendations for management of multiple different conditions while simultaneously incorporating patient preferences and available resources • WHEW!! • How best to do this? • Why is it so important?

  3. OBJECTIVES • Describe impact of multimorbidity on health care system • Practice 5 step approach to multimorbid patients • Elicit patient preferences • Consider evidence-based treatment options • Estimate prognosis • Determine clinical feasibility • Prioritize plan

  4. MULTIMORBIDITY • Definition: • Coexistence of multiple chronic diseases • Importance: • What percentage of Medicare recipients (>65yo) have multimorbidity? (guesses?) • ~70%! • How much of our annual healthcare budget is spent on multimorbid patients? • ~2/3 (over 300 BILLION dollars annually) Lochner KA, Cox CS. Prevalence of Multiple Chronic Conditions Among Medicare Beneficiaries, United States, 2010. Prev Chronic Dis 2013;10:120137 http://www.fightchronicdisease.org/sites/fightchronicdisease.org/files/docs/ChronicCareChartbook_FINAL_0.pdf Accessed September 3, 2013.

  5. MULTIMORBIDITY: 5 STEP APPROACH • Step 1: Elicit Patient Preferences • Does the patient prefer to make decisions alone? With caregivers? Does the patient defer decisions to the physician? • Recognize that general preferences may not apply to specific situations. Preferences need to be applied to decision at hand

  6. STEP 2: CONSIDER EVIDENCE-BASED TREATMENT OPTIONS • What evidence is available (if any)? • Does it apply to my patient? • What benefits might be expected? • What are the harms? • How long does the treatment take to achieve benefit?

  7. STEP 3: ESTIMATE PROGNOSIS • Does estimated prognosis or remaining life expectancy affect treatment considerations? • Consider time to treatment benefit

  8. STEP 4: DETERMINE CLINICAL FEASIBILITY • Consider patient ability to adhere to plan • Treatment regimen complexity • Patient education? • Non-pharmacologic measures?

  9. STEP 5: PRIORITIZE CARE PLAN • Putting it all together • Use strategies for choosing therapies that align with patient preferences, optimize benefit, minimize harm, and enhance quality of life for multimorbid patients

  10. PRACTICE! • Review multimorbid patient case in small groups • Work through your 5-step process to create a plan for your patient

  11. Summary/wrap up • Managing multimorbid patients: Not one right answer! • Use patient preferences as starting point and guide • Use decision model to help create an individualized, prioritized plan • Re-evaluate your plan at intervals and adjust as needed

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